Abstract
BackgroundUptake of human papillomavirus (HPV) vaccination is high overall but there are disparities in uptake, particularly by ethnicity. Incentivising vaccination consent form return is a promising approach to increase vaccination uptake. As part of a randomised feasibility trial we qualitatively assessed the acceptability of increasing uptake of HPV vaccination by incentivising consent form return.MethodsIn the context of a two-arm, cluster randomised feasibility trial, qualitative free-text questionnaire responses were collected from adolescent girls (n = 181) and their parents (n = 61), assessing the acceptability of an incentive intervention to increase HPV vaccination consent form return. In the incentive intervention arm, girls who returned a signed consent form (regardless of whether consent was given or refused), had a 1-in-10 chance of winning a £50 shopping voucher. Telephone interviews were also conducted with members of staff from participating schools (n = 6), assessing the acceptability of the incentive. Data were analysed thematically.ResultsGirls and parents provided a mix of positive, negative and ambivalent responses about the use of the incentive to encourage HPV vaccination consent form return. Both girls and parents held misconceptions about the nature of the incentive, wrongly believing that the incentive was dependent on vaccination receipt rather than consent form return. School staff members also expressed a mix of opinions on the acceptability of the incentive, including perceptions of effectiveness and ethics.ConclusionsThe use of an incentive intervention to encourage the return of HPV vaccination consent forms was found to be moderately acceptable to those receiving and delivering the intervention, although a number of changes are required to improve this. In particular, improving communication about the nature of the incentive to reduce misconceptions is vital. These findings suggest that incentivising consent form return may be an acceptable means of improving HPV vaccination rates, should improvements be made.Trial registrationISRCTN Registry; ISRCTN72136061, 26 September 2016, retrospectively registered.
Highlights
Uptake of human papillomavirus (HPV) vaccination is high overall but there are disparities in uptake, by ethnicity
Telephone interviews were conducted with six school staff members from four of the six participating schools
The purpose of this paper was to assess the acceptability of an incentive intervention to encourage the return of HPV vaccination consent forms for adolescent girls, their parents and participating school staff members
Summary
Uptake of human papillomavirus (HPV) vaccination is high overall but there are disparities in uptake, by ethnicity. Incentivising vaccination consent form return is a promising approach to increase vaccination uptake. As part of a randomised feasibility trial we qualitatively assessed the acceptability of increasing uptake of HPV vaccination by incentivising consent form return. A vaccination against human papillomavirus (HPV) was introduced in the UK in 2008. In the UK, uptake of the vaccination is high, with 87% of girls receiving at least one dose of the vaccine in 2015/2016 [2], there is considerable variation in uptake across the country, ranging from 68% in Brent, to 97% in Sunderland, and as high as 100% in areas with small populations [2]. In the UK and elsewhere in the world, there is evidence of assortivity of sexual mixing
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